Advertisement

Tramadol vs. Hydrocodone: Two Powerful Drugs for Pain

Tramadol and Hydrocodone

Tramadol and hydrocodone are two potent pain relievers. They can be prescribed individually or as combination drugs. These drugs have a powerful effect on your brain. They’re both highly effective pain relievers, but work in different ways and come with their own side effects.  

Read more to learn who they’re for and why they’re categorized as controlled substances.

Side-by-Side Evaluation

Tramadol has two different actions in the body. It is an opioid analgesic, which means that it attaches to receptors in your brain to change your perception of pain. It also works like an antidepressant, prolonging the actions of norepinephrine and serotonin in the brain. Tramadol is available under several brand names, including ConZip, Rybix ODT, and Ultram. Another medication, Ultracet, is a combination of tramadol and acetaminophen.

Hydrocodone is an extended release opioid analgesic sold under the brand names Zohydro ER and Hysingla ER. It’s also an ingredient in dozens of combination drugs, including Vicodin and Vicodin ES.

See a list of five surprising natural painkillers »

Due to the potential for overdose and abuse, in 2014 all hydrocodone products were moved to a new category by the Food and Drug Administration (FDA). They now require a written prescription, which you must obtain from your doctor and take to the pharmacy.

Tramadol is also a controlled drug, and prescriptions can be called to pharmacies, but many health systems are adopting more stringent guidelines on prescribing this drug.

Both of these drugs can affect your driving, since they make you drowsy. Do not drive or operate machinery while taking them until you know how you react to them.

Who They’re For

These drugs are commonly used to treat pain related to cancer or other chronic conditions. They may also be prescribed following an injury or surgical procedure. Tramadol and hydrocodone are generally prescribed for moderate to severe pain.

Zohydro ER and Hysingla ER are extended release drugs, which are intended for severe chronic pain when shorter acting medications have been ineffective.

Forms and Dosages

Tramadol tablets are available in 50 and 100 mg strength and are usually taken several times a day. Extended release versions come in 100 mg, 150 mg, 200 mg, and 300 mg strengths.

Hydrocodone extended release tablets are available in strengths ranging from 20 mg up to 120 mg. Extended release capsules come in strengths ranging from 10 mg to 50 mg. It’s critical that extended release products are taken whole. It’s unsafe to break or chew them.

Extended release capsules are generally consumed once a day, or every 12 hours as directed.

Because of their habit-forming properties, your doctor will decide on the lowest possible starting dose. The dosage can then be slowly increased.

Because of the danger of abuse, these drugs are classified as controlled substances. It’s illegal to give them to anyone else. The dosage considered safe for one person could be fatal to someone else.

Side Effects

Common side effects of tramadol include:

  • flushing
  • dizziness
  • congestion
  • sore throat
  • drowsiness
  • headache
  • itching
  • constipation
  • loss of appetite
  • nausea and vomiting
  • weakness

Most of these side effects will resolve within a few days.

More serious side effects of tramadol can include:

  • seizures
  • mood problems; there is an increased risk of suicide in depressed patients who take tramadol
  • hypersensitivity reaction, including swelling of the tongue or throat, trouble breathing, and skin rash

Get immediate medical attention (or call 911) if you experience these symptoms.

Common side effects of hydrocodone include:

  • dizziness
  • drowsiness
  • itching
  • constipation
  • loss of appetite
  • nausea and vomiting

Most of these side effects will lessen with time. 

Serious side effects of hydrocodone can include:

  • confusion or mood problems
  • low blood pressure
  • respiratory depression
  • gastric obstruction
  • hypersensitivity reaction, which could include swelling of the tongue or throat, trouble breathing, and skin rash

Get immediate medical attention (or call 911) if you experience these symptoms.

Hydrocodone comes with a black box warning about the potential for abuse and misuse of this drug. According to the Drug Enforcement Administration (DEA), hydrocodone is associated with more drug abuse than any other opioid.

Side effects of both drugs are more likely or can be more intense, if you are a senior, if you have kidney or liver disease, chronic obstructive pulmonary disease, or other chronic disease. 

Warnings and Potential Interactions

Signs of allergic reaction to these medications include swelling of the tongue or throat, trouble breathing, and skin rash. Get immediate medical attention (or call 911) if you experience these symptoms.

Your body may start to develop a tolerance to opioids. This may require you to increase your dosage to achieve the same effect. You may experience symptoms of withdrawal when you stop taking them. You’re more likely to develop a dependence on these drugs if you have a history of drug or alcohol abuse. If you have taken either drug for weeks or months, you may need help from your doctor to taper off the drug slowly to help prevent withdrawal.

Women who take opioids during pregnancy may give birth to babies who are dependent on the drug, and will go through opioid withdrawal. They may have to be given a gradual, tapered dose of the drug to prevent suffering. Opioids can also be passed to a baby through breast milk.

Potential Interactions

Tramadol has several drug interactions. Tell your doctor about all drugs and supplements you take, before you start taking tramadol.

These drugs should not be taken with tramadol:

  • carbamazepine
  • azelastine
  • orphenadrine

These are some of the drugs that interact with tramadol, but you may still be able to take them together. Talk to your doctor if you are taking any of these drugs:

  • anticholinergic drugs (antihistamines, drugs for urinary spasms and other drugs)
  • other opioids
  • MAO inhibitors
  • St. John’s wort
  • certain antidepressants
  • some antifungals
  • some HIV drugs
  • muscle relaxants
  • sleeping pills
  • triptans (used to treat migraine headaches)
  • anxiety and psychiatric medications 
  • warfarin

Hydrocodone has several drug interactions. Tell your doctor about all drugs and supplements you take before you start taking hydrocodone.

These drugs should not be taken with hydrocodone:

  • alcohol
  • azelastine
  • MAO inhibitors
  • orphenadrine

These are some of the drugs that interact with hydrocodone, but you may still be able to take them together. Talk to your doctor before taking hydrocodone if you are taking any of these drugs:

  • antidepressants
  • antihistamines
  • CNS depressants
  • CNS stimulants
  • magnesium sulfate
  • other opioids
  • sleeping pills and sedatives
  • sodium oxybate

Don’t drink alcohol when taking opioids. Other medications that cause sleepiness, including cough or cold formulas, may contain ingredients that interact with opioids or increase the risk of sedation. Tell your doctor and pharmacist about all the medicines you’re currently taking.

Deciding Which One to Take

Before your doctor can recommend an opioid, it’s important that you discuss all underlying medical conditions. List all your over-the-counter and prescription medications and supplements. Tell your doctor if you’ve ever had an alcohol or substance abuse problem.

Discuss the potential side effects and benefits of these and other opioids with your doctor. Together, you can choose the least potent treatment necessary to alleviate your pain.

Once you start taking the medication, tell your doctor about side effects right away so the proper adjustments can be made.

Read This Next

Vicodin vs. Percocet for Pain Reduction
Oxycodone vs. Hydrocodone for Pain Relief
Tramadol vs. Vicodin: How They Compare
Codeine vs. Hydrocodone: Two Ways to Treat Pain
Understanding Hydrocodone Addiction
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement
Advertisement